• Title/Summary/Keyword: 인대 재건술

Search Result 286, Processing Time 0.02 seconds

Immediate Full Weight Bearing in Extension Brace Following Arthroscopic Primary Repair or Reconstruction of ACL (관절경하 전방십자인대 일차수복술 및 재건술후 신전보조기를 착용한 조기 완전체중부하)

  • Kim Jung Man;Chang Cheong Ho;Cho Woo-Shin
    • Journal of the Korean Arthroscopy Society
    • /
    • v.1 no.1
    • /
    • pp.128-131
    • /
    • 1997
  • 전방십자인대의 일차수복술이나 재건술후에 장기간의 비체중부하가 필요한지를 결정하기 위해서 일차수복술을 시행한 96례와 재건술을 시행한 82례등 총 178례를 대상으로 술후 체중부하시기에따라 두군으로 나누어 비교분석 하였다. 모든 례에서 술후 보조기를 착용하였고 120례에서는 술후 첫6주간 점차적으로 관절운동범위를 증가를 시키고 다음 6주간은 완전운동범위 회복상태에서 유지후 술후 12주에 체중부하를 허용하였으며 나머지 58례에서 술후 완전신전상태에서 즉시 체중부하를 시켜서 정기적으로 Lachman검사, KT 2000을 이용하여 불안정성여부를 관찰하였다. 평균 추시기간은 4.2년(2년$\~$6년)이었고 불안정성에 대한 평가는 AMA 분류에 따랐다. 최종추시상 모든환자에서 1+이상의 불안정성은 발견되지 않았으며 술후 12주에 체중부하를 한군에서 1a+가 104례$(86.7\%)$, 1b+군이 16례$(13.3\%)$로 관찰되고 즉시 체중부하를 한 군에서 1a+가 51례$(87.9\%)$, 1b+가 7례$(12.1\%)$에서 보였으나 통계적으로 의미있는 차이는 없었다(P>0.05). 본연구의 결과로 전방십자인대 일차수복술이나 재건술후 신전보조기를 착용시키고 즉시 보행을 시키는 것이 술후 슬관절의 불안정성에 영향을 주지 않으며 안전한 재활방법으로 생각된다.

  • PDF

Isometry of the Posterior Cruciate Ligament (후방 십자 인대의 등장성)

  • Lee, Byung Ill
    • Journal of the Korean Arthroscopy Society
    • /
    • v.2 no.1
    • /
    • pp.15-20
    • /
    • 1998
  • Less has been written about the PCL than the ACL. There has, however, been an increasing amount of the interest in the PCL recently. Surgical reconstructions using grafts are often performed. However, these procesures often fail to provide long-term stability and function. Graft attachment sites are critical determinants of success in the PCL reconstruction. The clinical literature contains conflicting recommendations for graft attachment sites. We present a review of the isometry of the PCL.

  • PDF

Throwing injury of elbow

  • 최창혁
    • 대한정형외과스포츠의학회:학술대회논문집
    • /
    • 2003.11a
    • /
    • pp.158-166
    • /
    • 2003
  • 반복적인 투구동작은 성장기의 주관절에 손상을 주기 쉬우며 투구 시 통증을 유발할 경우, 투구를 중지하고 관절의 능동적 휴식을 통해 유연성을 회복하고 점차 근력강화운동을 시행해야 한다. 유소년기 Little league elbow의 주된 병변인 상완골 내상과 골단염을 포함한 대부분의 손상은 보존적 요법으로 치료가 가능하며, 굴곡구축 등의 운동제한을 동반한 통증이나 관절 내 유리골편 등의 감입으로 인한 증상이 있을 경우 수술적 치료를 요하며, 성인의 경우 내측 측부인대의 만성 불안정성 둥에 대해서 인대 재건술 등의 수술적 치료가 고려된다. 투구 시 주관절의 손상은 대부분의 경우 과 사용으로 인한 것이며, 특히 성장기에 손상의 예방이 무엇보다 중요하다. 따라서 부모와 코치 그리고 경기 관계자 둥이 성장기 소년의 근력과 관절의 상태가 성인과 다름을 이해하고, 운동의 강도와 횟수를 적절히 조절하며 손상시 조기치료를 받을 수 있는 환경을 조성하는 것이 필요하다.

  • PDF

Proper Surgical Methods of Posterolateral Rotatory Instability of the Knee (슬관절 후외측 회전 불안정성의 적합한 수술적 방법)

  • Jung Young Bok;Lee Yong Seuk;Song Kwang Sup;Jin Ho Sun;Lee Jong Seok
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.3 no.1
    • /
    • pp.49-55
    • /
    • 2004
  • Purpose: we would like to suggest the proper surgical methods according to the severity of instability by analyzing the results. Materials and Methods: Between January 1998 and August 2002, eighty five patients have been operated on because of posterolateral rotatory instability (PLRI). The materials were included the patients who had followed-ups for over 2 years in sixty one patients and the patient's assessments were done by clinical score (OAK, IKDC) and posterolateral drawer and dial test. Results: Through our results, the fibular tunnel turned out to be superior compared to the tibia tunnel method in rotational stability. Hughston-Jacobson methods and biceps tenodesis showed poor results. Fibula head tunnel was superior to tibia tunnel in rotational stabiliaty Conclusion: The surgical technique that passes the modified posterolateral corner sling through the fibula head tunnel may provide good clinical results in grade II PLRI. It is necessary to reconstruct both tibia and fibula tunnel in grade III PLRI. When there is combined varus instability, a positive result may be obtained if an additional LCL reconstruction is performed.

  • PDF

Intraoperative and Postoperative Complications After Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft (자가 골-슬개건-골을 이용한 관절경적 전방십자인대 재건술의 수술 중 및 수술 후 합병증)

  • Kim, Kyung-Tae;Lee, Song;Jeong, Soon-Young;Kim, Hyun-Soo;Park, Jun-Seong
    • Journal of the Korean Arthroscopy Society
    • /
    • v.6 no.1
    • /
    • pp.1-6
    • /
    • 2002
  • Purpose : Evaluation and analysis of the incidence and causes of intraoperative and postoperative complications after arthoscopic anterior cruciate ligament(ACL) reconstruction using bone-patella. tendon-bone (BPTB) auto graft. Materials and Methods : We reviewed 85 cases of arthroscopic ACL reconstruction using BPTB autograft which had been followed up for more than 1 year. Intraoperative complications had been recorded and corrected during the operation. Postoperative complications were analyzed and compared between 3 groups which were classified by the last follow-up period after the operation. Results : There were a few intraoperative complications including patellar fracture(1 case), contamination of harvested graft(1 case), impingement of graft(2 cases), blow-out of tile posterior wall of the femoral tunnel(1 case) and intraarticular retraction of the screw(1 case). The result of the comparison of postoperative complications among the groups shows that the incidence of anterior knee pain, donor site pain and patellofemoral crepitation were significantly decreased after 2 years. But there was no significant decrease in these complications after 3 years. Conclusion : Intraoperative complications after arthroscopic ACL reconstruction using BPTB autograft were due to incorrect technique and carelessness of the operation team, and can be prevented by improvement of surgical technique and accumulation of experience. Postoperative complication were somewhat unavoidable but gradually improved with time; hence, we should consider it for the selection of graft donor.

  • PDF

Factors Affecting Clinical Results of the Meniscal Repair (반월상 연골 손상의 봉합치료 결과에 영향을 미치는 인자)

  • Song, Eun-Kyoo;Rowe, Sung-Man;Chung, Jae-Yoon;Kim, Jong-Seok;Bae, Bong-Hyun
    • Journal of the Korean Arthroscopy Society
    • /
    • v.7 no.1
    • /
    • pp.63-69
    • /
    • 2003
  • Purpose : Clinical outcome of meniscal repair fur meniscal injury was examined and the factors affecting the outcome were determined. Materials and Methods : We examined 55 patients with meniscal injury who underwent arthroscopic meniscal repair and could be followed-up for more than 1 year. Clinical outcome according to Tapper & Hoover classification was examined in relation with age, gender, injury site, the presence of bucket-handle tear, method of repair, the period between injury to repair, and the concomitant reconstruction of anterior cruciate ligament. Results : According to Tapper & Hoover classification, the outcome was excellent in 29 cases, good in 23 cases and fair in 3 cases. Age and method of repair have significant relationships with clinical results according to Tapper & Hoover classification, but gender, injury site, the presence of bucket-handle tear, the period between injury to suture, and the concomitant reconstruction of anterior cruciate ligament have no significant relationships. Conclusion : A satisfactory results was obtained in $95\%$ of the patients with meniscal injury with meniscal repair. Age at injury and method of repair have significant relationships with clinical result statistically.

  • PDF

All-Inside Meniscal Repair Using FasT-Fix (FasT-Fix를 이용한 All-Inside 반월연골판 봉합술)

  • Jung, Yu-Hun;Choi, Nam-Hong;Kim, Byeong-Yeon
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.12 no.1
    • /
    • pp.24-28
    • /
    • 2013
  • Purpose: All-inside meniscal repair using FasT-Fix (Smith & Nephew Endoscopy, Andover, Massachusetts, USA) is a popular method for the meniscal tear. However, there was no report after all-inside repair using FasT-Fix for the meniscal tear in Korea. Therefore, the purpose of this retrospective study was to report clinical outcomes after all-inside meniscal repair using FasT-Fix. Materials and Methods: 25 consecutive patients underwent meniscal repairs using FasT-Fix for tears of the posterior horn of the medial or lateral menisci combined with hamstring anterior cruciate ligament (ACL) reconstructions. Postoperative evaluations included Lysholm knee score and Tegner activity scale. Using clinical criteria, a repaired meniscus was considered healed if there was no effusion or joint line tenderness, negative McMurray test, and no sense of giving way. Results: The average follow-up was 47.9 months (range, 40 to 61 months). At follow-up, the mean Lysholm score was 91.8 and the mean Tegner activity scale was 5.6. According to clinical criteria, 20 (80%) menisci was healed, and 5 (20%) failed. Conclusion: All-inside meniscal repair using FasT-Fix showed satisfactory results in patients with hamstring ACL reconstructions.

  • PDF

The Posterior Cruciate Ligament (PCL) Reconstruction by the Transtibial Tunnel Method using Cadaveric Achilles Tendon Grafts - Evaluation of the Initial Lengthening and the Slippage Ratio due to the Interference Screw Fixation and Double Cross-Pin Fixation - (사체 아킬레스건을 이용한 경골관통터널방식의 후방십자인대 재건술 - 간섭나사 및 이중고정핀 방식에 따른 초기연신 및 활주율 평가 -)

  • Kim, Cheol-Woong;Bae, Ji-Hoon;Oh, Dong-Joon
    • Transactions of the Korean Society of Mechanical Engineers A
    • /
    • v.33 no.4
    • /
    • pp.430-439
    • /
    • 2009
  • Posterior Cruciate Ligament (PCL) plays an important role in knee extension. Rotational instability due to injured PCL can be restored by various PCL reconstruction methods. In this study, the initial lengthening affected by fixation device and location was demonstrated, and furthermore, the slippage and the relationship between lengthening ratio and slippage ratio in the calcaneus and soft tissue fixation methods was newly suggested. Eight specimens of proximal tibia and Achilles tendon grafts were harvested from four cadavers and divided into four groups in regard to the four different types of transtibial fixation techniques. The cyclic load ranged from 50 N to 250 N applied to each graft fixed to proximal tibia in 55 degrees. The initial lengthening ratio to the total elongation has been approximately constant regardless of the fixation methods. The soft tissue fixation method with an interference screw showed about 56.4% slippage ratio to the total elongation and the same method with a double cross-pin presented about 45.4% slippage ratio. The soft tissue fixation method with an interference screw demonstrated approximately 2 mm less total elongation and about 13% more slippage than lengthening because of poor fixation compared to the same method with a double cross-pin.

Giant Cell Tumor of the Proximal Fibula Treated by En Bloc Resection (전 절제술로 치료한 근위 비골의 거대 세포종)

  • Suh, Jeung-Tak;Choi, Sung-Jong;Kim, Young-Goun;Kim, Jeung-Il;Kim, Hui-Taek;Yoo, Chong-Il
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.9 no.2
    • /
    • pp.200-205
    • /
    • 2003
  • Purpose: To report our experiences of clinical features, treatment method and results of giant cell tumor of 5 patients in proximal fibula. Materials and Methods: Five patients managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon followed up between January 1997 and July 2001. Preoperative plain radiograph and MRI and bone scan were checked. The recurrence of the tumor was judged by plain radiograph and clinical signs. Lateral instability of knee joint was checked during the outpatient follow-up. Results: The mean age of the patients at the time of operation was twenty- three (21-29). There were one male and four female patients. Dull pain was main symptom and palpable mass was seen in two patients. Peroneal nerve palsy and local recurrence were not observed except one case of temporary peroneal nerve palsy. During the outpatient follow up, one among 5 patients showed slight lateral instability and the other 4 patients showed no instabililty. Conclusion: Giant cell tumor in proximal fibula managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon showed favorable results.

  • PDF

Initial Fixation Power of Human Bone Interference Screw (인간 골 간섭 나사못의 초기 고정력)

  • Kim Jung-Man;Chung Yang-Kook;Kim Yang-Soo;Oh In-Soo;Koh Ihn-Joon
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.1 no.1
    • /
    • pp.26-30
    • /
    • 2002
  • Purpose: To estimate the initial and early phase fixation power of the human bone interference screw in reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone allograft. Materials and Methods: The results of twenty eight knees of reconstruction with bone-patellar tendon-bone allograft were analysed in 6 weeks, 12 weeks, 6 months and one year following operation. Physical examination including Lachman test, flexion rotation drawer test and jerk test were performed. The KT-1000 measurement was performed at the same time. In Lachman test 0 $\~$2mm anterior displacement of the tibia was considered normal. The KT-1000 measurement of normal side was compared with operation side and the difference of the two was recorded. The MRI was checked at final follow-up. Results: All but one knee showed normal in physical examination. The failed case showed proximal migration of the graft due to insufficient number of interference screw fixation in widened tibial tunnel. Conclusions: The human cortical bone interference screw showed sufficient initial and early phase fixation power in reconstruction of the anterior cruciate ligament.

  • PDF